Saturday, January 28, 2012

Prompted by reports of substandard care and abuse, the Senate is poised to pass much tougher standards for Florida’s assisted living facilities, but the initial reaction from key House members and lobbyists remains unclear as bills began to move Thursday.

There was no opposition Thursday as two Senate panels passed committee bills that would tighten Florida’s oversight of ALFs. The Senate Children, Families and Elder Affairs Committee passed SPB 7176, while the Senate Health Regulation Committee passed SPB 7174 – both of which would close ALFs when a resident dies of abuse or neglect.

The bills would also increase monitoring and criminal sanctions, boost the qualifications for administrators and staffers, and give residents and their families more protection.

“This could be really watershed legislation in protecting the lives of 80,000 individuals who live in assisted living facilities in this state,” Bob Sharpe, CEO of the Florida Council for Community Mental Health, told lawmakers. “If you’re successful in sustaining the provisions of this bill throughout the session, you will have done a remarkable thing.”

In the wake of last year’s Miami Herald investigative series “Neglected to Death,” lawmakers began responding to reports of dreadful conditions and care at some of the state’s nearly 3,000 ALFs. Statewide, residents were dying of abuse and neglect at a rate of nearly one per month. The Herald also found that inspections by the Agency for Health Care Administration had dropped 33 percent over the past five years, even as reports of abuse and neglect increased.

When nursing home abuse happens, most families feel helpless to their loved ones who were victimized. It is very common for families to not know what course of action to take and feel scared at the thought of seeking justice. In a record breaking-case, $200 million dollars was awarded to a patient’s family in a tragic elderly abuse case.

The 92-year-old victim was a resident at a nursing home and suffered from dementia. Her body was found at the bottom of a stairwell while she was strapped in a wheelchair. The staff at the nursing home testified that the door to the stairwell was supposed to be locked at all times but that many members of the staff disabled the alarm in order to go smoke. The nursing home had been cited multiple times with deficiency citations and abuse complaints while the aids stated that it was frequently understaffed. The case was against Trans Health Management Inc., who at the time had the sole authority to operate the home at the time.

Friday, January 27, 2012

A Massachusetts appeals court has verbally skewered a judge who ordered that a mentally ill woman have an abortion against her will even if it meant she had to be “coaxed, bribed, or even enticed” into a hospital.

The Massachusetts Appeals Court this week overturned the ruling by Norfolk Probate Judge Christina L. Harms, who had also ordered that the 32-year-old woman, known as “Mary Moe,” be sterilized.

The appellate decision noted that Moe “has consistently expressed her opposition to abortion” and likely would “continue to do so if she were competent.”

The facts in the case are not in dispute, according to court documents. Moe, who suffers from schizophrenia and bipolar mood disorder, is a few months pregnant. She has been pregnant twice before: The first time she had an abortion; the second time she gave birth to a boy who is now in the custody of her parents. Between her abortion and the birth of her son, she suffered a “psychotic break,” and has been hospitalized numerous times for mental illness.

At a December hearing, the state Department of Mental Health asked a court to grant temporary guardianship of Moe to her parents. That would allow the parents, who were already caring for one child, to give consent to an abortion for their daughter. (Court documents do not mention who the father is.)

Harms approved the guardianship, finding that Moe was incompetent to decide on an abortion based on “several and substantial delusional beliefs” -– including that Moe mistakenly believed she had a daughter and that she had previously met the judge.

According to the appellate ruling:The judge ordered that Moe's parents be appointed as coguardians and that Moe could be "coaxed, bribed, or even enticed ... by ruse" into a hospital where she would be sedated and an abortion performed.

Additionally:“...the judge directed that any medical facility that performed the abortion also sterilize Moe at the same time ‘to avoid this painful situation from recurring in the future."

The wishes of individuals declared mentally incompetent often go unheeded in family court, lawyers and social workers say, costing them control over the most personal decisions.

In light of this month’s stunning family court ruling that a woman diagnosed with schizophrenia should undergo an abortion and be sterilized, mental health specialists say the case, while an extreme example, casts light on an often unsettling reality for those deemed unable to make decisions for themselves.

Even when individuals voice opposition to a course of treatment, from antipsychotic medication to hospitalization, the courts often rule otherwise, lawyers say.

“It happens regularly,’’ said Robert Fleischner, an attorney at the Center for Public Representation in Northampton who specializes in mental health and disability law.

Those who work in the family court system generally praise Massachusetts for its progressive attitudes toward incapacitated individuals, saying their voices typically are allowed greater force here than in other states.

Yet many worry that the recent ruling, which only came to light when it was reversed on appeal, suggests there could be broader a problem at play, and it prompted concern that the courts are not consistently honoring the rights of those declared incompetent.

“To think a ruling like this could even happen once is extremely disturbing," said Rick Glassman, litigation director of the Disability Law Center of Massachusetts. No figures are kept on the number of court-ordered abortions and sterilizations in Massachusetts, but specialists say they are likely more common than typically assumed.

When Barbara Carey moved back to College Park to care for her 88-year-old mother last March, she was well aware that Helen Carey did not want to spend her final days in a nursing home.

Court records confirm that in 2006, Helen Carey had signed a living will and durable powers of attorney specifying that she remain in her home -- under her daughter's care -- until her death, with a family trust covering any necessary nursing or housekeeping expenses.

After examining Helen Carey on May 18, 2011, Dr. Peter Rabins, professor of psychiatry and behavior sciences at Johns Hopkins, stated in a report to the Prince George's County Circuit Court that she was "an alert elderly woman ... with no evidence of depression. She can remain in her home if the resources are available."

Less than a week later, however, Judge Sherrie Krauser ignored her own medical expert and ordered Helen Carey transferred from the Lanham hospital where she had gone for observation after suffering chest pains to an Adelphi nursing home.

Attorney Jeanne Aelion, a temporary guardian appointed by Krauser, allowed her daughter only a one-hour supervised visit per week.

In a July 1, 2011, email, Helen Carey's court-appointed attorney, W. David Allen, told Barbara Carey: "I am informed that after consulting with Dr. Peter Rabins, Helen Carey is being given Zoloft, an antidepressant. I believe this is prescribed to address her apathy." Another email, dated Aug. 1, stated that Dr. Rabins "agreed with the use of Zoloft."

But Barbara Carey, a physical therapist in Fairfax, knew that Zoloft (sertraline) was contraindicated for the treatment of depression in Alzheimer's patients because Dr. Rabins himself had co-authored several articles making this very point.

She also knew her mother did not tolerate Zoloft, and that her thyroid problem mimicked symptoms of depression. On Aug. 31, she asked the court to order a second medical opinion. Her petition was denied.

Barbara Carey told The Washington Examiner that after being prevented from seeing her mother at all for two weeks, she was shocked at her condition on Sept. 15. "She was clearly still on medication. Her heart was racing. She could hardly walk."

According to court documents obtained by The Washington Examiner, a tense standoff between the daughter and the guardian occurred that day: "My mother is in medical distress. Her pulse was over 200. The guardian was right there. I told her, 'She is in tachycardia. She needs medical help.' "

Five days later, while Barbara Carey was still desperately trying to get the governor's office and the Maryland Department of Aging to intervene, Helen Carey died of cardiac arrest.

Despite Allen's emails and Barbara Carey's own observations, a subsequent investigation by the department found no record that Helen Carey had ever been taking any psychotropic drugs. Both Dr. Rabins and attorney Allen refused to comment when asked to explain this apparent discrepancy.

"If the investigation is correct," Barbara Carey told The Washington Examiner, "it indicates either an error or altered records." Medication errors should be of interest to state regulators, and altering medical records is a crime, but the state of Maryland apparently isn't interested either way.

Before Kenneth Bryan Holcomb shot and killed a homeless man in San Mateo County in 1992, he had been in prison for burglary and drug dealing. While he was serving a 22-years-to-life sentence for the murder, he fractured his spine during a fight, which left him a quadriplegic, unable to walk, dress or bathe himself.

Holcomb speaks with some difficulty, although he is able to see and hear, Patrick Sparks, his lawyer, said during a medical parole hearing last September. Yet Sparks said that his client retained “the capacity in his mind for dangerousness,” a transcript shows. “Not to say that he’s the Godfather or anything, but he’s a pretty dangerous guy,” he said.

Even so, the California Board of Parole Hearings found that because of Holcomb’s disabilities “the conditions under which the inmate would be released will not pose a reasonable threat to public safety.”

Today Holcomb lives in the Idylwood Care Center, a private 172-bed nursing home in a leafy suburban neighborhood in Sunnyvale, near a park and a private school. He and three other medical parolees from the California Department of Corrections and Rehabilitation — murderers, drug dealers and burglars, ranging in age from 40s to 70s — are watched by medical staff instead of by prison guards.

The four are among the first 29 prisoners to be granted medical parole under a 2010 California law intended to save the state tens of millions of dollars in medical and guarding costs for permanently, medically incapacitated prisoners. Some of the parolees are bedridden, while others can be moved by wheelchair, and officials said that the parolees posed no threat to others.

“There are worries involved in putting prisoners in with the regular population of frail seniors, but there is a lot of risk involved in putting them in with psych patients,” said Wanda Hale, who visited the Idylwood Care Center as the program manager for the long-term care ombudsman program at Catholic Charities in Santa Clara County. “My concern is that there is a lot of potential for problems. They just haven’t happened yet.”

Facilities that care for medical parolees are not required to inform other patients or their families about the parolees. The ombudsmen receive no formal notification when medical parolees are transferred to facilities in their region.

The Senate's Human Services Committee voted this week to approve legislation to strengthen the independence and accountability of a program intended to defend the rights, safety and welfare of long-term care residents in California in light of recent scrutiny.

"There is warranted concern that California's State Ombudsman program is not effectively advocating for residents," said Senator Lois Wolk, D-Davis, noting recent studies by both the Senate Office of Research and the Senate Office of Oversight and Outcomes.

SB 345 would reinforce the independence of the politically-appointed state ombudsman from the California Department of Aging, which currently oversees the program, and require increased accountability for the ombudsman's advocacy efforts.

Wednesday, January 25, 2012

A battle is raging between two sides of a family and a sick man is caught in the middle.

Laurie Chism and her brother and sister fear time is running out for their father, 74-year-old Jim Chism.

The Chism children are embroiled in a battle to take guardianship of their father from his wife, who they believe is deliberately letting their dad die.

Chism is being treated at a psychiatric facility in Mount Clemens. He was moved there after having a hallucination the day after Thanksgiving.

His children, who live out of town, say Chism’s wife of more than 20 years ultimately got doctors to sign off on a transfer to a mental institution.

Chism’s kids filed paperwork Monday in Macomb County court to get an emergency hearing to take guardianship of their father.

As for their stepmother, the Chism’s believe she is battling depression over her own struggle with cancer and may be trying to take control of Jim’s assets, including his chiropractic business. We tried to get her side of the story, but she declined.

It’s not yet clear if a judge will take up the emergency petition for guardianship.

That's the reason Brian Marsack gave his victims, according to one victim’s daughter, after allegedly bilking them out of their life savings by posing as a Goldman Sachs investment broker.

Edward Mancini, 91, his late wife, Joan, 79, his sister Virginia Cox, 77, and his sister-in-law Florence King, 87, lost $1.2 million combined.

They have little hope of getting it back -- joining hundreds of other senior citizens cheated out of billions of dollars a year, according to a study by MetLife.

Prosecutors say Marsack, 44, sold the family phony high-interest investments and sent them what were supposed to be interest checks each month. Edward Mancini, who knew Marsack since he was a child, said he now believes the checks were likely small amounts of his own money.

Marsack eventually confessed his crime to Mancini, but the only remorse his victims say he showed was his fear of going to jail. Marsack is to appear in 41B District Court on Jan. 25. He is charged with two counts of false pretenses, a 10-year-felony, and one count of racketeering, a 20-year felony.

Local officials responded to 350 cases of elder abuse in 2011, most of them financial exploitation. If the first month of the new year is any indication, 2012 will be another tough year for seniors in the area.

In 2007 Rita Finch moved into her parents home to become their primary caretaker. Her mother is 84 and her father is 87.

Since the summer of 2011, [Finch's father has] been bombarded with letters and phone calls from people trying to turn his life's savings into a fortune. "Somebody offered to make him a million dollars in six months, and he fell for it," Finch said. She said the opposite has happened. "Their money is all gone."

Denise Armstrong with Big Sky Senior Services said it's the latest scam, and it's already affected at least two people in Billings. The alleged scam convinces seniors to start their own website where they can buy and sell merchandise.

Tuesday, January 24, 2012

Once there were five candidates for Cook County judge in a Southwest Side district dominated by Democratic boss Mike Madigan.

There was the incumbent judge, who had been a criminal attorney for 20 years before his appointment last year. There was also an attorney for the city of Chicago, a public defender and an assistant Illinois attorney general.

And there was that fifth candidate, who suffered from an acute shortage of legal experience.

But what does experience matter when it comes time to don the black robes and dance along The Chicago Way?

Though short on courtroom time, the fifth candidate did have something more valuable: oodles of political chops. And he had the Mount Olympus of political hack jobs, executive director of the Cook County employee pension fund. But his most outstanding qualification was that his father was the political brain (and fist) of former Mayor Richard M. Daley.

So guess how many candidates are left on the ballot now? If you said "just one," meaning the political guy with the father with the clout, you'd be right.

Say hello to future Judge Daniel R. Degnan, the son of Tim Degnan, Daley's political hammer.

One by one, the other candidates dropped out. At least two had their petitions of candidacy challenged by the incumbent and withdrew before a hearing. Then it was down to two candidates: Degnan and Judge Tom Carroll. According to several sources, Judge Carroll got a message of his own: It's not your turn anymore.

Now, Daniel R. Degnan is running unopposed as a Democrat in the 3rd Judicial Subcircuit. In practical terms, that means he'll have a job for life, with a six-figure salary and no heavy lifting and all those holidays off with pay.

Monday, January 23, 2012

Financial caretakers appointed to assist the elderly and disabled in Outagamie County face more stringent requirements after a former guardian was charged with siphoning nearly $500,000 from clients.

New rules that took effect Jan. 1 are aimed at adding safeguards to the guardianship system that prosecutors say was exploited by Jeffrey M. Schend of Appleton.

Schend faces a trial in March on six felony counts of theft and one misdemeanor theft charge. In watchdog reporting after his arrest last year, The Post-Crescent found that he operated within a system that relied largely on his word alone.

State law does not require detailed audits, the newspaper found. Even if the law did, the oversight office in Outagamie County would not be able to handle the workload, its director said at the time.

Generally, the new rules require guardians to provide more detailed financial records to Outagamie County's circuit courts as part of their responsibility to clients who are deemed incompetent to handle their own affairs.

Also, county officials now will choose guardianship cases randomly each year for review, and those guardians will be required to give the court all receipts and canceled checks for the year. And, the rules also establish fines for guardians whose failure to answer questions about their work require court intervention.

"It's a good idea," said Gary Apitz of Bryant, guardian for his 63-year-old developmentally disabled brother who lives in an Appleton nursing home. Schend had served as the guardian for Apitz's brother when he lived in Shawano County. A judge there ordered Schend to pay nearly $5,000 based on the man's unpaid bills.

"Every guardian should be responsible to explain what he's done," Apitz said.

Nearly 50 years after country star “Gentleman” Jim Reeves died in a Brentwood plane crash, a Nashville judge will settle once and for all the fate of his still-lucrative musical legacy.

On Monday, a trial gets under way in Davidson County Probate Court to decide the proper division of the income from Reeves’ royalties — which earn as much as $400,000 annually for the estate of the late singer best known for the lyric “Put your sweet lips a little closer to the phone.”

The trial will determine how much Terry Davis — the man who married Reeves’ widow, Mary Reeves Davis — is entitled to in his dispute with Reeves’ nephew and niece. The legal dispute has continued without resolution since Mary’s death in 1999.

On Friday during a pretrial hearing, Davidson County Probate Judge Randy Kennedy denied Davis’ request to postpone the trial once more, but allowed Davis to fire his current attorney — his sixth in the case.

Three of Davis’ former attorneys were also in court, seeking to join the case in an effort to recoup more than $100,000 in unpaid legal fees for representing Davis. The judge denied their motion, suggesting the attorneys would have to stake their claims after the trial.

Davis said outside of court on Friday that the case would likely include some “surprises” and expressed bitterness toward the Reeves heirs he has been battling in court for more than a decade.

Sunday, January 22, 2012

Should corporate lobbyists decide whether safe equipment and procedures are needed if you or a loved one have to go to a hospital or nursing home? Or should health care professionals make those decisions?

That’s the type of issue being debated in our Statehouse and in Congress over safeguards that protect the public’s health and safety.

This month, special interest lobbyists convinced the U.S. House of Representatives to pass a bill — the REINS Act — designed to make it practically impossible for federal health and safety experts to set standards that all corporations must follow. No major safeguard could be adopted unless every single word were approved by Congress.

The U.S. Chamber of Commerce urged the Senate to pass the House bill, arguing it would prevent “intrusive” regulation of the health care and banking industries, in particular.

Studies show the typical nurse lifts 1.8 tons during each shift. Before mechanical lifting devices were required in N.J. hospitals and nursing homes, more than half of nurses reported that they had suffered costly injuries from lifting and moving patients.

Similarly, proven measures to reduce violence against caregivers — lighting, alarms, communication systems, training and more — had been well-known. But these steps were not legally required of all facilities. Fifty-two percent of hospital nurses and radiology technologists reported experience with violence or physical harassment on the job, and patient safety suffered as well.

Fortunately, caregivers, their unions and workplace safety organizations were able to persuade then-Gov. Jon Corzine and the state Legislature to enact statewide standards. By this month, hospitals and nursing homes must establish committees made up of at least 50 percent front-line caregivers to choose and deploy safe lifting devices, violence prevention measures and other required protections.

During hearings on these laws, nurses and other health professionals presented research showing that investing in these safeguards had saved millions of dollars in other states. Facilities saved on medical payments and workers’ compensation; overtime, recruiting and training costs to cover for injured workers; administrative down time; and much more.

Yet corporate CEOs continue to try to block such health and safety protection. They want to use the REINS Act and other legislation to make it easy for corporate lobbyists to block meaningful federal standards on clean air and water, workers’ rights, consumer protection and many other issues. They want to pass legislation in New Jersey that would bar the state from adopting safeguards that the federal government hasn’t enacted.

Safe lifting and violence prevention rules for hospitals and nursing homes are among standards that either don’t exist in our state or are weaker at the federal level.

...Citizens will be able to access Hospital Report Cards from the state Department of Public Health Web site under HB 1562/Public Act 97-0171, as well as access information about income, sales, property and business taxes imposed across the state through the Department of Revenue’s Web site under SB 43/Public Act 97-0353....

...Adult Therapy Requests (HB 785/PA 97-0165): Attempts to provide short-term crisis counseling for adults under guardianship to address cases where the guardian is abusive or neglectful. Authorizes any adult to request and receive counseling services or psychotherapy, even if the adult is under guardianship. Establishes that the adult’s guardian will not be informed of counseling or psychotherapy unless the counselor or therapist believes such disclosure is necessary. States that if the counselor or therapist intends to disclose the counseling or psychotherapy, the adult must be informed....

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NASGA (National Association to STOP Guardian Abuse, Inc.) is a 501(c)(3) public-interest, civil rights organization formed by victims of unlawful and abusive guardianships and conservatorships. We seek legislative reform of existing law and upgrading of criminal penalties for court-appointed fiduciaries misusing protective proceedings for unjust enrichment and engaging in elder and family abuse.

Our mission is to promote the safety and well being of vulnerable persons subject to injury and damage in their person and property through unlawful and abusive guardianship and/or conservatorship proceedings; to end the growing violations of due process, civil and human rights; to work towards ultimate legislative reform of guardianship as presently practiced; upgrading of criminal penalties for court-appointed fiduciaries misusing protective proceedings for unjust enrichment; and to be a support organization for victims and their families. We carry out our mission through research, outreach, education and advocacy; and going forward, by alliance with community interest, law reform, civil rights and other advocacy organizations.

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